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Quick Facts

What is asthma? Asthma triggers Asthma is a chronic condition that obstructs A trigger is something that can cause airflow, but the obstruction is reversible. It an individual to have an asthma attack. involves difficulty in due to: Some examples include: • Inflammation (swelling) • Allergens (pollens, animals, , mold) • Mucus in the airways • Irritants (cold air, chemicals and sprays, • Tightening of muscles around the airways ) • Exercise • Upper respiratory

A trigger is something that can cause an individual to have an asthma attack.

What increases an individual’s chance for developing asthma? How common is asthma? Individual characteristics: • About 8% of Utah adults, aged 18 and older, • Genetic makeup currently have asthma (Source: Utah BRFSS, • Age 2004) • Sex » Males - 7.3% • Race » Females - 8.7%

Medical conditions: Asthma signs and symptoms • Low birth weight • Coughing • Obesity • Wheezing, a whistling sound when breathing • Respiratory as a child • • Allergies • Chest tightness • Sneezing and runny nose • Itchy and inflamed eyes

Symptoms may be mild, moderate, or severe in and exposure to intensity, or even life-threatening. Symptoms are more commonly experienced at night. second-hand smoke increase the risk of developing asthma. page Asthma Quick Facts

How is asthma treated? Rescue medications Asthma cannot be cured, but it can be con- More common rescue medications include: trolled by avoiding triggers and using medica- tions to control symptoms. • Albuterol (e.g., Proventil) • Pirbuterol (e.g., Maxair) Generally there are two types of medications: • Ipratropium bromide and albuterol (e.g., • Controller or long-term Cobivent) • Rescue, quick-relief or short-term Rescue medications work quickly and relax the Both types of medications are important in muscles around the airways making it easier helping control asthma. Each type is used for to breathe. These medications give temporary different purposes. relief and their effects can last up to 4 hours. Rescue medications don’t treat the swelling or mucus in the airways and when they wear off, Controller medications the muscle tightening can return. These medications are taken daily. More com- mon controller medications include: • (e.g., Serevent) • Fluticasone (e.g., Flovent) It is important to seek medical • Cromolyn (e.g., Intal) care if you have asthma. • Montelukast (e.g., Singulair)

Controller medications (long-term) treat the Poorly controlled asthma can lead airway swelling or inflammation, the main to: problem of asthma. These medications re- • Urgent care and emergency room visits duce the swelling, prevent excess mucus from • Hospitalizations developing and help prevent the muscles from contracting around the airways. They also help • Sick days make the airways less “twitchy” or irritated. • Activity limitations Controller medications are taken at least once daily • Lower quality of life and prevent asthma attacks from happening long term. They should be taken until stopped by your doctor. What YOU can do if you have asthma • Identify and minimize contact with asthma triggers • Understand and take medications as prescribed • Recognize early signs that asthma is getting worse • Know what to do if asthma is getting worse page Work-Related Asthma

What is work-related asthma? Work-related asthma may not appear for weeks Work-related asthma is asthma that is caused or months following exposure, as it takes by, or is made worse by, exposures or triggers time for the body to become sensitive to the in the workplace. Over 250 workplace agents substance(s) causing asthma. Once asthma has are associated with work-related asthma. See developed, symptoms may occur at lower levels Table 1 for common examples. of exposure to the substance(s). Table 1: Work-related Asthma Triggers How common is work-related Type of Substance Examples asthma? Air pollutants tobacco smoke, • Up to 20% of all asthma adult cases may diesel exhaust, be work-related asthma agents, , gases and vapors • Of those diagnosed with work-related Dusts wood, rock, coal, asthma: (organic/inorganic) protein dusts, » 20 – 27% are those with pre-existing silica, , latex asthma who experience aggravated Fumes and vapors chemicals, cleaning asthma attacks due to workplace materials, welding, exposures solvents, , » Up to 80% are new asthma cases due anhydride from to work-place exposures heating and cooling metals quickly Molds all varieties How can work-related asthma be Pollens trees, flowers, weeds prevented? Gases , • Use to reduce expo- ammonia, , sure by: sulfur dioxide, , » nitrogen oxides Modifying work processes and install- ing enclosures Mists paints, lacquers, » Automating work procedures varnishes, spray, pesticides, cleaning » Installing local exhaust ventilation products, acids, etc systems • Use individual preventative measures by: » Minimizing exposures to known When is asthma work-related? asthma triggers Do symptoms: » Using appropriate respiratory • Occur only at work or occur regularly after equipment the work shift? • Improve on week-ends or vacations? • Increase over the course of the work week? • Improve after a change in the work environ- ment? page Work-Related Asthma

Work-related asthma resources Treatment of work-related • American Association www.lungusa.org asthma is not different than • Asthma and Allergy Foundation of America “ordinary” asthma. www.aafa.org • Asthma Program, Utah Department of www.health.utah.gov/asthma How is work-related asthma • American Academy of Family treated? – Patient Education Asthma cannot be cured, but it can be con- http://familydoctor.org trolled by using medications to control symp- • Canadian Centre for Occupational Health toms and prevent asthma attacks, or by avoid- and Safety ing and/or minimizing exposure to triggers. www.ccohs.ca/oshanswers/diseases/asthma. Generally there are two types of medications: html • National Heart Lung & Blood Institute • Controller or long-term www.nhlbi.nih.gov/health • Rescue also called Quick-relief • Occupational Safety and Health Association Both types of medications are important in www.osha.gov/SLTC/occupationalasthma/ helping keep asthma under control. Each type is used for different purposes. References American Lung Association, Asthma in Adults Fact Steps to take if workplace Sheet, July 2005. http://www.lungusa.org. exposures are affecting your Arnaiz NO, Kaufman JD. New developments in work- 1. Gather information about: related asthma. Clin Chest med. 2002 Dec; 23(4):737- • Symptoms you are experiencing 47 • When these symptoms began Cullinan, P., Clinical aspects of . • How often you have these symptoms Panminerva Med, 2004. 46(2): p. 111-20 • Time of day or week that symptoms are Henneberger, P.K., et al., Work-related exacerbation of worse asthma. Int J Occup Environ Health, 2002. 8(4): p. • Times that you feel better (e.g., when not 291-6. working) Lombardo, LJ & Balmes JR. (2000) Occupational • Why you feel symptoms are related to work asthma: A review. Perspec- tives Supplements Volume 108 (S4), August, 2000 • List of substances or materials that you are exposed to at work (see Material Safety Occupational Respiratory : Your Data Sheets (MSDSs) available at your workplace and your lungs, www.familydoctor.org workplace) • List of previous jobs, hobbies, and smoking Utah Department of Health, Asthma Program, habits that may have or be affecting your www.health.utah.gov/asthma lungs 2. Share the above information with your page doctor. COPD Chronic Obstructive Pulmonary Disease

What is COPD? Symptoms of chronic Chronic Obstructive Pulmonary Disease, also and emphysema: known as COPD, is comprised of a set of lung The symptoms of chronic bronchitis and em- diseases that limits air flow and is not fully re- physema are similar. versible. It is usually progressive and is associ- ated with inflammation of the lungs as they -re Chronic Bronchitis Emphysema spond to harmful particles or gases. Treatment Chronic Chronic cough is available. COPD can be prevented by taking Shortness of breath Shortness of breath proper precautions and avoiding triggers. Frequent clearing Limited activity level of throat Two major types Increased mucus Chronic Bronchitis • Characterized by the presence of chronic What can cause COPD? inflammation and excess mucus production and the presence of a chronic productive The primary risk factor for COPD is smoking. cough. Long-term smoking is responsible for 80-90% of cases. A smoker is 10 times more likely to It is estimated that 14 million people in the die of COPD than a non-smoker. U.S. suffer from this disorder. Other risk factors include: Emphysema • Characterized by damage to the small, sac- • Childhood respiratory infections like units of the lung that participate in the • Genetic make-up delivery of and removal of carbon dioxide from the lung. • Increasing age • Prolonged exposure to harmful particles It is estimated that 2 million individuals in the and gases (secondhand and industrial smoke, U.S. suffer from this disorder. chemical gases, vapors, mists and fumes, and dusts from grains, materials and minerals)

How common is COPD? • About 13.9% of the U.S. adult population, ages 25 and older, have been diagnosed with COPD » 15 – 19% of COPD cases are work- related • 24 million other people have evidence of troubled breathing, indicating COPD is un- der diagnosed by more than 60%

Smoking cessation is critical for all severities of COPD. page COPD Chronic Obstructive Pulmonary Disease

What do we know about COPD When is it important to see a in the mining industry? doctor? Studies show: • When first experiencing shortness of breath or other lung symptoms • An increased number of cases of chronic bronchitis in coal and gold miners • If symptoms get worse • Long-term exposures to low levels of silica Seek emergency medical treatment if: may lead to the development of chronic • Breathing suddenly becomes more difficult bronchitis and emphysema • Chronic exposure to coal dust, particularly Note: If you are currently diagnosed with high levels, can cause severe emphysema COPD, see your doctor 1-2 times a year to review treatment plan.

How is COPD prevented or its progression slowed? Resources on the Internet • www.lungusa.org • Avoid exposure to second-hand smoke and • www.nhlbi.nih.gov/health/COPD other harmful substances in the air • www.emphysema.net • Stop smoking to prevent further damage

How is COPD treated? References American Lung Association. Breathing at Work, Treatment is different for each individual. It is Workplace Exposures can Generate Breathing Hazards. based on severity of symptoms. www.lungusa.org Early diagnosis and treatment can: American Lung Association. Chronic obstructive pulmo- • Slow progress of the disease nary disease (COPD) Fact Sheet. 2003.

• Relieve symptoms Centers for Disease Control, Department of Health and • Improve an individual’s ability to stay active Human Services, CDC Programs in Brief-Workplace • Prevent and treat complications Health and Safety- Work-Related Lung Disease. 2005. • Improve quality of life National Heart, Lung, and Blood Institute, National Institutes of Health. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Medications used to treat COPD symptoms or Pulmonary Disease (Updated 2003) - Executive Sum- to decrease the risk for complications include: mary. 2003. • - to relax the muscles around the airways • Steroids - to reduce inflammation • Oxygen therapy - to help with shortness of breath • Annual flu vaccine - to reduce the risk of the flu and its complications • vaccine - to prevent a common page cause of pneumonia

What is silicosis? Sources of exposure Silicosis is caused by exposure to respirable • Sandblasting for surface preparation crystalline silica dust. Crystalline silica is a • Crushing and drilling rock and concrete basic component of soil, sand, granite, and • Masonry and concrete work most other types of rock, and is used as an (e.g., building and road construction and agent. Silicosis is a progres- repair) sive, disabling, and often fatal lung disease. Cigarette smoking adds to the lung damage • Mining/tunneling; work caused by silica • Cement and asphalt pavement manufacturing

Effects of silicosis • Lung - silica has been classified as a Preventing silicosis human lung • Use all available engineering controls such as blasting cabinets and local exhaust • Bronchitis/Chronic Obstructive Pulmonary ventilation Disorder (COPD) • Avoid using compressed air for cleaning • (TB) - Silicosis makes an surfaces individual more susceptible to TB • Use water sprays, wet methods for cutting, • Scleroderma - a disease affecting skin, blood chipping, drilling, sawing, grinding vessels, joints and skeletal muscles • Substitute non-crystalline silica blasting • Possible renal disease material • Use respirators approved for protection against silica; if sandblasting, use abrasive Symptoms of silicosis blasting respirators • Shortness of breath • Do not eat, drink or smoke near crystalline • Dry, nonproductive cough silica dust • Possible fever • Wash hands and face before eating, drinking or smoking away from exposure areas • Fatigue • Loss of appetite • Chest pain • , which may eventually lead to death

For more complete information: OSHA Occupational Safety and Health Administra- tion US Department of Labor page www.ohsa.gov Beryllium Disease

What is beryllium? How can beryllium disease be A metal found as a component of coal, oil, prevented? certain rock minerals, volcanic dust and soil. It • Use engineering controls to reduce expo- is not harmful when held or touched. Howev- sure, such as er, beryllium particles are a health when » Modifying work processes and install- they become air born in the process of cutting, ing enclosures grinding or otherwise working with it. » Automating work procedures » Installing local exhaust ventilation systems What is beryllium disease? • Use individual preventitive measures, such as Beryllium disease refers to various conditions » Wearing protective clothing and respi- that result from exposure to beryllium and its ratory protective devices compounds or alloys. Exposure to beryllium » Showering and changing clothes at the most often occurs in mining, extraction and end of the work day in the processing of alloy metals containing beryllium. More common types • Beryllium sensitization - a person’s im- mune system responds to the exposure • Chronic beryllium disease - a slowly pro- gressive that is treatable, but cannot be cured. It involves scarring of the lungs and may be fatal. It can take *WARNING* years to develop after the first beryllium exposure. Inhaling beryllium dust or fumes Less common type may cause serious, chronic lung • Acute beryllium disease - has a sudden, rapid onset during or following high levels disease, or cancer. It can be fatal. of exposure. Improved workplace controls have almost eliminated this form of the disease. page Beryllium Disease

Symptoms Treatment Beryllium Sensitization Beryllium Sensitization • No symptoms • No treatment • Positive for sensitivity Chronic beryllium disease • There is no known cure, but with treatment, progress of the disease may be slowed. Acute Beryllium Disease • Treatment goals: • Inflammation of the lung, windpipe, skin, eyes, nose and/or throat » Improve symptoms » Improve oxygen levels in bloodstream (Oxygen therapy) Chronic Beryllium Disease » Protect lungs from further damage • Nonproductive cough • Breathing difficulties • Chest pain Resources/References • ’s national Occupational Health and • General weakness Safety Resource. www.ccohs.ca/oshanswers/ • Loss of appetite diseases/beryllium.html • Weight loss • National Jewish Center www.nationaljewish. org/disease-info/diseases/occ-med/beryllium/ • Formation of masses of tissue in the lungs about/beryllium/index.aspx (granulomas) • Day, GA, Stefaniak, AB, Weston, A, Tinkle, SS. • Possible formation of granulomas in the skin, (2006) Beryliium exposure: dermal and im- liver, spleen, kidney, bone, nervous system, munological considerations. Int Arch Occup skeletal muscles, lymph glands or wall of Environ Health. 79:161-164 heart

page Black Lung Disease

What is Black lung disease? Symptoms of black lung disease Black lung disease results Early stages from inhaling coal dust • No symptoms or non-productive cough and carbon over a long period of time. Coal dust Later stages settles in the lungs, caus- • Shortness of breath ing them to harden and • Deceased tolerance for exercise make breathing difficult. • May have emphysema with productive cough It is a chronic, progres- • May have progressive massive sive, disabling, and often fatal lung disease. There are two types: simple • May have failure of right side of heart and complicated. The complicated form, • Respiratory failure, which may eventually sometimes referred to as progressive massive lead to death fibrosis, affects less than 2% of those with the simple form. The complicated form involves progressive scarring of the lungs, which leads Preventing black lung disease to premature disability and death. Cigarette • Use engineering controls smoking adds to the lung damage caused by • Wear well-fitted appropriate respirators coal dust. • Participate in a respiratory protection program Sources of exposure • Underground coal mines Treatment • Preparation of coal for transport • Eliminate or minimize exposure to dust • Transporting coal • Stop smoking • Treat symptoms Results of prolonged exposure to • Use oxygen therapy as needed coal dust may result in • Chronic Obstructive Pulmonary Disorder 1. The Mereck Manual of Medical Information Online (COPD) comprised of chronic bronchitis and/or emphysema Medical Library, Second Home Edition. Black Lung. Last reviewed/revised 2/1/2003. http://wwwmerck. • Simple form of black lung disease com/mmhe/sec04/ch049.html • Complicated form of black lung disease, progressive massive fibrosis 2. U.S Department of Labor, Mine Safety and Helath Administration, National Min Safety Academy, “Dust • Silicosis, if the quartz content of the coal is high - What you can’t see can hurt you.” 1999 • Both black lung disease and silicosis page AsbestosAsbestis Diseases

What is asbestos? Asbestis is a naturally occurring silicate . Signs and symptoms will vary from person to person and the What diseases are associated type of asbestos disease. with asbestos? • - inflammation that results in Signs and Symptoms scarring of the lung tissues Early Symptoms • Nonmalignant - thickening and calcification of lung disease • No symptoms • Cancer of the lung, , • Shortness of breath with activity • - a cancer affecting the lining • Dry cough of the lungs or abdomen Later stages • Gastrointestinal cancer • A persistent and productive cough (a mucus producing cough) • Chest tightness or pain Means of exposure • A dry, crackling sound while inhaling • Inhaling dust that penetrates deep into the lungs • Swallowing dust that is “coughed up” Sources of exposure • Eating contaminated food • Underground and open-casting mines Asbestos diseases occurs usually 15 or more • Asbestos product manufacturing (insulation, years after initial exposure. The risk of de- roofing and building materials) veloping increases significantly in • Demolition and renovation of buildings those with a history of exposure to asbestos containing asbestos and . Family members may • yards also be at risk for asbestosis if exposed to • Automotive repair (brakes and clutches) page transported on work clothing. • Power plants and steel mills Asbestos Diseases

Preventing asbestos diseases Treatment • Use engineering controls to reduce • Eliminate or minimize future exposure to exposure, such as asbestos » Enclosing dust sources • Stop smoking » Using wet methods to prevent dust • Obtain pneumonia vaccinations generation • Obtain an annual flu vaccination » Substituting or using alternatives to • Treat bacterial infections promptly asbestos • Supplement oxygen, if needed • Use individual preventative measures » Wear an appropriate respirator » Shower and change clothes at the end References of the work day • http://www.atsdr.cdc.gov » Avoid eating and drinking in exposure areas • APHA Preventing and Injury, 1991, page 114-125. • Rosenstock L, Cullen MR, Brodkin CA, Redlich CA Textbook of Clinical Occupa- tional and Environmental Medicine, 2nd Edit., Together, smoking and asbestos Philadelphia, El Sevier, 2005, p 374-377 exposure significantly increase • Asbestos Exposure and Your Job: At-Risk Occupations, Industries and Locations your chance of developing one http://www.mesothelioma-facts.com/atrisk. of the asbestos diseases. cfm

page Respiratory Disease Educational Materials Asthma, COPD, Silicosis, Black Lung, Beryllium, and Asbestos Diseases Mining Industry

Respiratory Disease Educational Materials Asthma, COPD, Silicosis, Black Lung, Beryllium, and Asbestos Diseases Mining Industry

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